Healthcare Provider Details

I. General information

NPI: 1326046640
Provider Name (Legal Business Name): WELLS HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3362 BUCKLAND SQ
OWENSBORO KY
42301-5829
US

IV. Provider business mailing address

725 HARVARD DR
OWENSBORO KY
42301-6185
US

V. Phone/Fax

Practice location:
  • Phone: 270-689-0930
  • Fax: 270-689-9348
Mailing address:
  • Phone: 270-926-9355
  • Fax: 270-684-6283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number20010303003
License Number StateKY

VIII. Authorized Official

Name: MR. TERRY LYNN SKAGGS
Title or Position: CFO
Credential:
Phone: 270-926-9355